This month, the National Psoriasis Foundation is urging patients and rheumatologists to take charge of psoriatic disease by setting ambitious treatment goals to achieve better health outcomes…
Molecular Profile Hints at Inflammatory Processes in Chronic Fatigue
(Reuters Health)—People with severe symptoms of chronic fatigue syndrome have a molecular signature in blood made up of 17 immune system signaling molecules that are elevated, which may provide insight into how inflammation contributes to the condition. “Of the 17 cytokines that correlated with severity, 13 are proinflammatory, likely contributing to many of the symptoms…
Immune Response to Trauma May Flag Impending Organ Failure
NEW YORK (Reuters Health)—Early immune response signatures in the critically injured may shed light on mechanisms underlying multiple organ system failure, according to U.K. investigators. As Dr. Joanna M. Shepherd of Queen Mary University of London tells Reuters Health by email, “Multiple organ dysfunction syndrome (MODS) is common after major trauma and it contributes to…
Advancements in Diagnosis, Treatment for Antiphospholipid Syndrome
CHICAGO—Doruk Erkan, MD, MPH, a rheumatologist at the Hospital for Special Surgery and Weill Cornell Medicine in New York City, described recent developments in the field of antiphospholipid syndrome (APS) to the rheumatologists gathered for the ACR’s State-of-the-Art Clinical Symposium in April. He introduced APS as a “field with limited data and lots of controversies,” although,…
Amyloidosis Is Often Underdiagnosed, Undertreated
CHICAGO—Caryn A. Libbey, MD, clinical associate professor of medicine at Boston University School of Medicine, described the evolving in our understanding of amyloid at the ACR’s State-of-the-Art Clinical Symposium in April. Amyloidosis is a rare disease that is often underdiagnosed and undertreated. “Even though this disease has been around for 150 years, I still consider it…
A Stiff Man: A Case Study in Ankylosing Spondylitis
First Appearances I watched the old man, his back painfully bent, shuffle toward the scale. A blocky rigidity draped over him. His feet seemed stuck to the floor. His head hung heavily over his chest. Observing him from the end of the hallway, instead of a face, I saw only a mound of shaggy, matted…
Clinical Guidelines for Sjögren’s Syndrome Focus on Biologics, Fatigue, Inflammatory Musculoskeletal Pain
The first clinical practice guidelines for Sjögren’s syndrome have been released, the culmination of an initiative by the Sjögren’s Syndrome Foundation.1 These standard-of-care recommendations are intended to provide consistency in practice patterns, inform coverage and reimbursement policies, lead to the design and implementation of educational programs, highlight the needs for future research and fill a…
Somatic Mosaicism Can Complicate Diagnosis of Autoimmune Disease
New methods of gene sequencing have resulted in improved identification of mutations in patients and increased availability of genetic testing in rare diseases. Despite these exciting advances, a majority of patients lack identifiable mutations and the underlying disease etiology remains an enigma. Somatic mosaicism (SM) may be an explanation for some of these clinically challenging…
Rheumatologist Dr. Sandra Pagnussat Recalls Journey from Patient to Physician
When she was in elementary school, Sandra Pagnussat, MD, began experiencing unrelenting pain and stiffness, first in her pinky and then in her other fingers. Her pediatrician diagnosed her with polyarticular juvenile idiopathic arthritis (JIA). In high school, Sandra decided to pursue a career in medicine and began taking advanced placement classes in biology and chemistry….
Psoriasis May Itch as Intensely as Atopic Dermatitis
NEW YORK (Reuters Health)—Itch intensity in moderate to severe plaque psoriasis can be substantial, and may be on a par with the notoriously itchy skin condition atopic dermatitis, new research suggests. “Both conventional wisdom and some of our classic dermatologic textbooks have stated that psoriasis is not particularly itchy,” corresponding author Dr. Alexa B. Kimball…
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